Dr. H. Gilbert Welch, one of the country’s top health care policy scholars, has resigned from his faculty position at Dartmouth College, after an investigation by the school concluded that he had committed research misconduct.
“I am saddened to say that I am resigning from Dartmouth,” Welch wrote in an email to colleagues Thursday. “I feel that I can no longer participate in the research misconduct process against me — as I fear my participation only serves to validate it.”
STAT and Retraction Watch reported last month that an internal Dartmouth investigation found that Welch plagiarized material from a Dartmouth colleague and a researcher at another institution for a 2016 paper published by the New England Journal of Medicine. The paper concerned how breast cancer screening led to the overdiagnosis of tumors and unnecessary treatments.
The investigation found that Welch “engaged in research misconduct, namely, plagiarism, by knowingly, intentionally, or recklessly appropriating the ideas, processes, results or words of Complainants without giving them appropriate credit …”
Welch told STAT and Retraction Watch for the report last month that the paper was a “natural progression” of his research and that “the underlying data are publicly available — all the analyses, all the figures, an all the writing in the article are my co-authors’ and mine.” He added that the dispute centered on “the origin of the idea — not about the validity of the work.”
In his email to colleagues, Welch wrote that the dean of Dartmouth’s medical school had proposed that, as punishment, Welch contact the journal to revise the authorship of his paper by listing the complainant as first author and that Welch could stay employed by the institution but not be allowed to teach.
“I cannot in good conscience accept the demand that I make the complainant an author — much less the demand that I make him the first author,” he wrote. “Doing so requires that I falsely attest that he meets the requirements of authorship: namely, that he materially participated in the work and is able to defend it. Much as I have enjoyed working at Dartmouth, I am not willing to falsely attest to anything simply to stay here.
“Furthermore, the demand that I no longer teach subverts the very reason I came to work at Dartmouth.”
Welch was a professor at the Dartmouth Institute for Health Policy and Clinical Practice and also held positions at the medical school, business school, and college.
Welch wrote that he had respected the confidential nature of the investigation for nearly two years “and never wanted it to become public. But that changed when the complainant chose to release confidential documents from the investigation to STAT in mid-August, and I now feel compelled to respond.”
In documents Welch emailed Thursday, he argued that Dartmouth’s verdict in the case was at odds with the conclusions of the New England Journal of Medicine and the U.S. Office of Research Integrity. Both groups, Welch said, agreed that his actions did not rise to the level of “idea plagiarism” or research misconduct but rather were a dispute over credit.
Welch acknowledged being intrigued by his colleague Samir Soneji’s data, which he first saw in 2015 at a seminar Soneji was giving. He asked for and received a slide, and noticed what he says were several errors. Welch said that he communicated with Soneji about trying to improve the analysis, but that he didn’t seem interested. Meanwhile, Welch said he fixed the errors and made his own figure with the corrected data — a figure that found its way into the NEJM article.
In other words, Welch argues, Soneji’s data was an influence, but in reverse. “Ironically, it’s [sic] biggest influence was simply because I realized it contained errors. That is what drove me to look directly at the data myself,” he wrote.
Welch said Dartmouth got hung up on the similarity of the NEJM figure with Soneji’s rather than looking at the data themselves.
And he dismissed the notion that the information was novel.
“It was the product of ideas and methods I have been using for decades — ideas and methods that are the result the influences that many others have had on my career,” he wrote.
Welch concluded the email by telling his colleagues, “For nearly 30 years, I have been blessed to be able to work with the many fine staff, faculty and clinicians at Dartmouth. It has been an honor to work with all of you.”
Welch is a prominent scholar and author whose work focuses on unnecessary medical screenings and interventions that can drive up health care costs and harm patients.
Soneji declined to comment on the resignation.
Soneji has filed a grievance with Dartmouth in which he claims to have been the victim of retaliation for his complaint against Welch. The grievance alleges that he felt pressured to consider entering into mediation with Welch — presumably putting a halt to the investigation. The investigation went forward, however, and there was no mediation. And he implies in the grievance that the 10 percent salary bump he received when he was promoted earlier this year was less than it should have been and may have been an effort to penalize him for speaking out against his renowned colleague.
Neither Welch nor Dartmouth immediately responded to requests for comment.
Ivan Oransky of Retraction Watch contributed reporting. This story is a collaboration between STAT and Retraction Watch.
About the Authors Reprints
I’ve read a couple of Dr Welch’s books and I enthusiastically agree with his premise of over-screening, over-dx-ing and over-treatment in medicine. I worked in the industry for many years and have seen it for myself. I have seen it in my own experience with the system. I can’t comment on the plagiarism charge, but Dr Welch’s explanation makes perfect sense to me. It seems a real shame he is gone from Dartmouth; I hope he is somehow involved in research and teaching elsewhere.
They used a minor thing as an excuse to get rid of him because he challenged their business model of overtreatment.
Translation: “You can’t fire me, because I quit.”
Other translation: “I couldn’t copy his work, because it was filled with errors anyways.”
Final translation: “Everyone else does it too, I am not the only one who borrows and influences others.”
The biggest losers here are Dartmouth students, who won’t be taught by a gifted teacher and a superb researcher. NEJM and the Office of Research Integrity deemed this an authorship/credit dispute, not a matter of plagiarism. And the disputed idea was one that Dr. Welch and others, including his co-author Dr. Barry Kramer have been exploring for decades and did not originate with the complainant.
Stat has done Dr. Welch and readers a disservice by publishing the confidential document provided by the complainant. You should also fix the headline that says that Dr. Welch “plagiarized colleagues’ work.” It’s simply untrue.
Dr Welch was really popular and his ideas about unnecessary medical care were distorted and politicized. They were used to justify the denial of medical care to people that needed it. Dr Welch did not apply any economic or billing data to his research, if he had he would have found the relationship with marketing and profits.
Published medical research sometimes has a very sloppy methodology due to problems with the review process. All too often, the reviewers accept or deny a publication based on whether they agree with the findings, and they ignore any methodological shortcomings if they agree with those findings. I have often shared these articles with a bistatistician, who is a former colleague, and she is typically shocked when articles are published with obvious methodological mistakes.
Bruce, welcome to my world. Quite literally every article published in the last 5 years showing savings from wellness is obviously wrong on its face. There is a saying that “in wellness, you don’t have to challenge the data to invalidate it. You merely have to read the data. It will invalidate itself.” Here is a compilation of these hilarious lies.
https://scholarlycommons.law.case.edu/healthmatrix/vol27/iss1/3/
Dr. Welch is the reigning deity in overdiagnosis and I started my entire company –Quizzify — to bring his (clearly original!) findings to the employer/employee population, which definitely needs it. They have been hoodwinked by wellness vendors into screening the stuffing out of employees to hunt for disease and then push employees into the medical system and brag to the employers about how many sick employees they found.
The wellness industry takes overdiagnosis to a new plateau. We call it “hyperdiagnosis.” Without him, the wellness industry has one less impediment in its quest to turn all employees into patients.
See http://www.theysaidwhat.net for more info on this industry.